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Straight talk

NATIONAL REPORT — According to the recent "Compassionate Care Online Survey" from Virbac Animal Health, 47 percent of veterinarians have end-of-life discussions with their clients more than 11 times per month. How these conversations unfold, experts say, is key to a client's comfort with their choice in extending or ending a pet's life.

It's a crucial conversation, experts say, and practitioners should take the time to find common ground with the client when addressing the pet's quality of life and/or the realities of caring for a terminally-ill animal.

Clients can be resistant to the idea of terminating a beloved pet's life, and in broaching the subject, timing is everything, says Cindy Adams, PhD, MSW, associate professor of veterinary clinical and diagnostic sciences at the University of Calgary.

"Even though the vet may want to dispel their belief that the animal is suffering, the timing needs to be attended to," Adams says. "That often lands way too early on and the client's ability to process information is (inhibited), so the client becomes resistant or angry."

Spend time understanding the client's perspective, Adams suggests. "Try to secure some common theme between the doctor and the client," she says. "Often that is (accomplished by showing) interest in the patient. Show you understand (the pet's) struggle, and that you are both committed to ensuring it doesn't suffer anymore."

Learning, or already knowing, an animal's quality-of-life indicators aids the discussion as well, says Dr. Kate Knutson of Pet Crossing Animal Hospital and Dental Clinic in Bloomington, Minn. With her clients, she says, "We talk about quality of life and what the client perceives is important to the pet."

Knutson provides the example of her own Doberman, which died of heart failure last November. "I knew she didn't want to be bed-ridden," she says. "I knew she had to have certain happiness quotients for her to feel life was worth living—to go outside and run around without me stopping her ... and to eat food with gusto." Focusing on those quality-of-life indicators, she says, will help clients and veterinarians chart the most appropriate course for a patient. "Every pet is different, just like people," she says. "Some people would be fine in a wheelchair and some wouldn't want to live. Pets are the same."

To that end, a quality-of-life scale can be a useful communications tool. While Adams cautions that some clients may not be receptive, others find it helpful.

"It may be useful to sit down and go through it, but manage it appropriately," she says. "Don't send them off with it." As a discussion tool, she says, it can be an enabler when it comes time to make a decision. "If a vet sees something different than the client when scoring alongside them, it can be facilitative," she adds.